| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99283 |
|
818 |
738 |
$131K |
| 99284 |
|
359 |
332 |
$61K |
| U0003 |
Cov-19 amp prb hgh thruput |
510 |
484 |
$46K |
| 96361 |
|
127 |
106 |
$39K |
| 43239 |
|
84 |
79 |
$35K |
| 99285 |
|
73 |
66 |
$28K |
| 97110 |
|
526 |
162 |
$15K |
| J0702 |
Betamethasone acet&sod phosp |
804 |
720 |
$7K |
| 0002A |
|
72 |
62 |
$5K |
| 0001A |
|
88 |
80 |
$4K |
| 97140 |
|
220 |
61 |
$3K |
| 80053 |
|
681 |
637 |
$3K |
| 73130 |
|
12 |
12 |
$2K |
| 96374 |
|
232 |
214 |
$1K |
| 87635 |
|
13 |
12 |
$937.36 |
| J3010 |
Fentanyl citrate injection |
1,163 |
999 |
$404.52 |
| J2250 |
Inj midazolam hydrochloride |
1,034 |
830 |
$404.52 |
| 85025 |
|
2,389 |
2,167 |
$396.43 |
| 88305 |
|
650 |
384 |
$388.02 |
| 80048 |
|
14 |
13 |
$349.86 |
| 93005 |
|
125 |
101 |
$103.16 |
| J7030 |
Normal saline solution infus |
319 |
268 |
$27.94 |
| J7120 |
Ringers lactate infusion |
646 |
581 |
$0.00 |
| J3301 |
Triamcinolone acet inj nos |
286 |
251 |
$0.00 |
| 99152 |
|
40 |
38 |
$0.00 |
| Q9966 |
Locm 200-299mg/ml iodine,1ml |
653 |
559 |
$0.00 |
| 0753T |
|
272 |
164 |
$0.00 |
| J2704 |
Inj, propofol, 10 mg |
918 |
733 |
$0.00 |
| 96375 |
|
90 |
79 |
$0.00 |
| J1100 |
Dexamethasone sodium phos |
70 |
60 |
$0.00 |
| J2795 |
Ropivacaine hcl injection |
444 |
389 |
$0.00 |
| J2001 |
Lidocaine injection |
139 |
129 |
$0.00 |
| J2003 |
Inj, lidocaine hcl, 1 mg |
29 |
28 |
$0.00 |
| J7050 |
Normal saline solution infus |
12 |
12 |
$0.00 |